JMIR Publications

ABSTRACT

Background:

Infectious-disease-specific health literacy (IDSHL) is a crucial factor in the development of infectious diseases. It plays a significant role not only in mitigating the resurgence of infectious diseases but also in effectively averting the emergence of novel infections such as COVID-19. Since the three-year COVID-19 pandemic, there has been a dearth of research concerning IDSHL and its subsequent focal points for health education.

Objective:

The study aimed to (1) identify the IDSHL scores of residents in 2019 (before the COVID-19 pandemic) and 2022 (the post-epidemic period of COVID-19), (2) evaluate the changes in IDSHL between the two scores, and (3) explore the risk factors affecting IDSHL among residents using multivariate logistic regression analysis.

Methods:

A multiple-stage stratified random sampling technique was used to select study participants from 30 counties in Zhejiang Province, China. We used a standardized questionnaire consisting of 12 closed-ended questions to measure the IDSHL scores before and after the COVID-19 pandemic. Participants were excluded if they were foreigners; residents of Hong Kong, Macau, or Taiwan; or unable to communicate in Mandarin. Two-round cross-sectional survey data were obtained for 2019 and 2022 using the same methodology. Standard descriptive statistics, chi-square tests, and t-tests were used to analyze the data.

Results:

The two-round cross-sectional surveys conducted in 2019 and 2022 yielded 19,257 and 18,857 valid questionnaires, respectively. In terms of IDSHL scores, when comparing 2022 to 2019, there were notable statistical differences in both the overall scores (t=16.789, P<.001) and the scores across the three dimensions of knowledge (t=6.731, P<.001), behavior (t=20.096, P<.001), and skills (t=13.537, P<.001). With regard to the questions, all but two exhibited statistical differences (P<.001). Multivariate logistic regression analyses indicated that the 2022 year group had a higher likelihood of possessing acquired IDSHL than the 2019 group (OR=1.323, 95% CI: 1.264-1.385, P<.001).

Conclusions:

When conducting health education, it is imperative to enhance efforts in non-respiratory infectious disease health education as well as education in respiratory infectious diseases such as COVID-19. Health education interventions should prioritize minority populations with poor self-health status and low education.